36_-091_letterAG Maple Ridge Rd- application for endorsementFORM A
t / NORTHAMPTON, MA
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File five completed forms and plans and one mylar with the City Clerk and the
Planning Hoard in accordance with the requirements of Section 3.02.
To the Planning Hoard:
The undersigned, believing that the accompanying plan of his/her property
in the City of Northampton does not constitute division within the meaning of the
Subdivision Control Law, herewith submits said plan for a determination and
endorsement that Planning Board approval under the Subdivision Control Law is not
required.
1. Applicant C l l`t
Print or type name Signature
i s Lo caA Sri S%. Prop.! �i r S14
Address Phone
2.
Owner S N-�A f kiL"t
Print or type name Signature
Address
3. Surveyor Ii I L 1. F a !, f a titX S
Print or type name Signature
Phone
Address / Phone
4. Deed or property recorded in �! A Registry,
Book Page
S. Location and Description of Property:+�� �i ��� �i e. Td -
IJ*
I. N /' --l'- 9
6. Assessor's Hap ID: A Lot(s):
Date Submitted for Planning
Board Approval:
City Clerk:
(Signature)
(4/11/91)
Date Planning Board
Decisio"ilbd:
((JJ-
City C ell • - ��
(Signature
�- SUBDIVISION REGULATIONS -------PAGE 60